by Juliette Sterkens
Only a few weeks ago, a hearing aid user stood up in a local Hearing Loss Association of America group meeting and told of his first “hearing loop moment” and how it almost made him cry. He spoke of how he encouraged two hearing aid using friends to have their telecoils activated, so they too would be able to hear well in church.
But his friends discovered they had been sold hearing aids without telecoils. One was told his hearing wasn’t “bad enough” to benefit from a telecoil and the other was informed he had failed to choose a hearing aid with a telecoil and that telecoils were old technology anyway.
Christine, another attendee, recounted her experience several years ago when she asked for an activated telecoil. Her audiologist couldn’t understand this request. Few places were looped, so why bother? The audiologist was unaware that Christine’s small rural church had just been looped. Soon Christine, who was so impressed with the benefits, had a loop installed to help her hear TV and computer conversations with grandkids via Skype and looped her Toyota Prius! She then helped foster nearly another dozen loops in her community. Since Christine discovered telecoils she has been happier with her hearing aids.
Hearing aid satisfaction is tied to multiple environmental listening utility (MELU) as demonstrated by Sergei Kochkin. It makes sense that consumers are happier with their hearing aids when they find them helpful in many important situations. At best, hearing aids restore the loss of audibility by 50%. This means the more severe the hearing loss (or the SNR-loss as measured by a speech-in-noise test), the more residual hearing loss remains and thus the more situations will likely remain problematic to the consumer. Bluetooth wireless microphone options can be very useful in one on one or small group situations, but they can also be intimidating to less tech-savvy clients, and they are not a viable solution for use in public places. For this a telecoil is indispensable. Not telling clients about telecoils is like buying car and not having been told that it has headlights, so you can drive it at night!
Yes, telecoils and hearing loops may have been around for a long time but in the last decade loop installation techniques have vastly improved and their performance is ruled by the recently adopted IEC 60118.4 (2015) Standard. This standard – think of it as a Real-Ear test for a loop – specifies the magnetic signal strength, the frequency response of the signal (100-5000Hz), the dynamic range of the loop system and allowable electro-magnetic interference levels. The manufacturers of hearing loop drivers make every effort to properly train installers and to ensure that hearing loop designs meet standards. This means that a loop meeting the IEC standard, coupled with a telecoil that meets the Nordic Standard, provides an incredibly clear signal with improvements in signal-to-noise ratio values akin to personal FM systems. 
The sound that goes into a hearing aid is analog. The sound that comes out of the hearing aid is analog. It is the hearing aid that digitally processes sounds picked up by the microphone and/or the telecoil. A hearing loop broadcasts the purest analog sound from a lectern, pulpit, TV or other sound source, wirelessly via magnetic waves to the hearing aid. A hearing loop input avoids the unnecessary complication of digital sound transmission processing problems and delays that some users experience with Bluetooth transmission. In a loop the user is no longer hearing an acoustic input subject to the inverse square law and deleterious effects of background noise and reverberation, but receives a clear and clean analog input as if his or her ear is near the mouth of the speaker.
I believe that fostering loops starts with counseling clients on the elephant in the room: hearing aids often lack benefit in the very same places they came to see us about in the first place (in their house of worship, local theater or meeting room) but, that these limitations can be overcome by using a telecoil (or a wireless Bluetooth microphone in a car or restaurant situation.) That our clients do not hear well in public was demonstrated in a survey published in the Hearing Review where 866 people were asked to rate the performance of their hearing aids or cochlear implants using a 10-point scale. The average response was only 4.9 in a non-looped public setting—and 8.7 in a looped environment!
Empower clients with the knowledge that hearing in a public venue is a civil right and that the ADA and Assistive Listening Systems (ALS) are installed for them. Encourage clients to ask for them, and if none are offered, to demand that reasonable accommodations be made. If these requests are ignored, encourage them to file a complaint with the Department of Justice. That is what led Kinney Drugs Stores, in a settlement with the NY State Attorney General , to installing hearing loops at every one of their pharmacy counters.
You say, there are not enough hearing loops in your area to warrant fitting telecoils? The phone use of telecoils is reason enough. Moreover, hearing loops will increase if we all work together. Let’s take it upon ourselves to always ask for an assistive listening device and verify its performance when going out in public venues, speak up when systems are not offered, when neckloops aren’t working well, or signage is lacking. Share this information with clients in your practice or on your website. Shower venues with praise when effective ALS are offered, volunteer your ear (or those of your active, community minded clients) to help to improve the system where needed, and advocate for consumer preferred hearing loop technology where none exists.
I dream of a world where every audiologist fosters one or two hearing loops in their community, and where every user of occluding ear mold hearing aids is taught to self-advocate for them. This way we would quickly reach a national tipping point, one that I believe I have reached in North East Wisconsin. To me, this is what caring about ‘America’s Hearing’ is all about.
What’s not to like about being able to hear? It doesn’t matter whether the technology is old or new—as long as it helps our clients hear. Hearing loops offer simplicity of use (no need to seek out or fuss with extra equipment or linking or pairing), affordability (telecoils are essentially free), energy efficiency (with no drain on battery power), and customized sound (unlike the generic sound output of theater headsets).
To hear the difference in and out of the loop, Google “hearing loop” on YouTube. Several videos demonstrate this truly remarkable technology that users love—yet many audiologists keep labeling as “old technology”. But so is the wheel, the airplane, the wineglass. The latter may be “old technology” but it won’t stop me from enjoying a glass of wine tonight.
How to “Get Looping”
I am happy to help you get your community in the hearing loop. I offer tutorial for audiologists on how to start this process and www.hearingloop.org offers a wealth of additional information. Or email me at [email protected]. I’m am happy to help you get started.
References
Kochkin S: Increasing hearing aid adoption through multiple environmental listening utility. Hear J2007;60(11):28-31.
Kochkin S, Sterkens J, Compton-Conley C, Beck DL, Taylor B, Kricos P, Caccavo M, Holmes A, Powers TA. Consumer Perceptions of the Impact of Inductively Looped Venues on the Utility of Their Hearing Devices. The Hearing Review, 35(5), October 2014, 16-26.
Remensnyder L Invigorate your Practice with Hearing Loops: A How to Guide for the Practitioner. Audiology Practices 2011; 3 (4): 32-35 and 61.
Sterkens J: Get your Practice and Patients in the Loop: Telecoil and Hearing Loop Essentials for Practitioners. Audiology Practices 2011; 3 (4): 36-39
Sterkens J: Roadmap to a Looped Community. Audiology Today 26 (3): 26-31. Sterkens J: Get your Practice and Patients in the Loop: Telecoil and Hearing Loop Essentials for Practitioners. Audiology Practices 2014; 3 (4): 36-39 retrievable at www.loopwisconsin.com/Images_PDF/SterkensATMayJun.pdf
Juliette Sterkens, AuD is on her encore career as the hearing loop advocate with the Hearing Loss Association of America. In this quasi-volunteer role, she speaks around the country to consumers and professionals to foster better access for hearing aid and cochlear implant users.
Telecoils are so important when you purchase your hearing aids. The fact is some hearing health providers do not turn them on or tell their client the importance of including them in hearing aids. Hearing Loss Association of America (HLAA) provides this information before shopping for your next hearing aids.
Thanks for your comment. I could not agree with you more about the importance of telecoils and HLAA has been beating this drum for years. From where I sit – it appears that the tide is turning (though at times it feels like we are turning an aircraft carrier), many MFRs are offering hearing aids with telecoils, they are improving the telecoil performance (Starkey just introduced the Muse and Halo-2 with better positioned and stronger T-coils) and from what I hear, more reps are making it a point to discuss this with the providers. I am also working with a large MFR to create telecoil and hearing loop materials that hearing healthcare providers can share with their clients – something that is sorely needed. I am hopeful that Better Hearing Institute and HIA (the Hearing Aid Industry) will make this kind of material available to all the MFRs. After all, hearing loops help to improve the performance of all T-coil equipped hearing aids.
For the slight uplift in pricing I always ordered t-coil just in case, though now I’m told the differential can be negligible . Yet, at a local HLAA when I made a presentation on Loops, attempting to get traction in my area for support and solicitation for compliance, I was politely told it was old technology .Some professionals who do not experience hearing loss will not support it, not encourage anyone else. I’m a ci recipient but still believe in loops!